There is still no reliable, specific biomarker for precision diagnosis and clinical monitoring of systemic lupus erythematosus. The aim of this study was to investigate the importance of the ...determination of immunofenotypic profiles (T, B lymphocytes and NK cells) and serum cytokine concentrations (IL-17 and IFN-alpha) as potential biomarkers for this disease.
The study included 55 patients with SLE and 25 healthy controls. The proportion of T, B, NK cells were assessed in peripheral blood using flow cytometric assays while the serum cytokine concentration (IL-17 and IFNalpha) was determined by ELISA test.
ROC curve analysis showed good accuracy to distinguish between patients and healthy individuals for activated T cells (AUC=0.798; p<0.001), Treg (AUC= 0.651; p=0.036), and memory B cells (AUC=0.285; p=0.002). We found statistically significant difference (p=0.036) in the levels of serum IL-17 between patients with SLE (IL-17=49.27 pg/mL) and controls (IL-17= 28.64 pg/mL).
Significant increase in the relative number of Treg lymphocytes, and decrease in memory B cells, as well as decrease level of IL-17, in SLE patients may be implicated in the pathogenesis of the disease. These parameters, as biomarkers, could distinguish SLE patients and no-SLE patients. Monitoring subpopulations of immune cells in peripheral blood using flow cytometry provides insight into abnormal T and B cell function in SLE. Progress in understanding the immunity at SLE, results in concrete benefits for the SLE patients, which include new clinical management and therapeutic strategies.
Introduction: Burns, depending on the degree of severity, induce a significant pathophysiological response in the body. The complement system participates in the body>s defenses as well as in immune ...responses after burn-induced trauma. Objectives: The main objective of the study was to examine how burn severity affects serum C3 and serum C4 complement values; whether burn severity correlates with serum C3 and C4 complement, and establish the predictive value of the serum C3 complement and serum C4 complement for assessing the severity of the burn. Patients and methods: According to the degree of TBSA, patients were classified into three groups: group with %TBSA < 15% (30 patients), group with %TBSA > 15%-25% (30 patients), and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups partial-thickness burns (39 patients) and full-thickness burns (51 patients). We followed laboratory parameters: value serum C3 complement and serum C4 complement on the first and seventh day after burn trauma. Results: Serum C3 complement was significantly lower in patients with %TBSA > 25%-40% and in the group with %TBSA > 15%-25% compared to patients with %TBSA < 15% on the first and seventh day after burn trauma. Serum C3 complement was significantly lower in patients with %TBSA > 15%-25% compared to patients with %TBSA < 15% on day one and day seven after burn trauma. Serum complement C4 was not significantly different between burn groups on the first and seventh day. Full-thickness burns have significantly lower levels of serum complement C3, compared to partial-thickness burns, on the 1st and 7th day. Full-thickness burns result in a decrease in serum C4 complement compared to partial-thickness burns on the 7th day after burn trauma, but this decrease is not significant. On the 1st day after burn trauma, we found a negative correlation between %TBSA with serum C3 complement. Serum C4 complement was not correlated with %TBSA on the day 1st. Conclusions: %TBSA and depth of burn result in a significant decrease in serum C3 complement but not serum C4 complement. There is a negative correlation of %TBSA and C3 complement but not serum C4 complement on the 1st day after burn trauma. Serum C3 complement is a significant predictor of burn severity. The predictory significance of the C4 complement is not statistically significant.
Introduction: Burn, depending on the degree of severity and depth, induces significant pathophysiological response of the body. Our study is the prospective study for assessment of T lymphocyte ...immunological changes in patients with burns, with different degrees of %TBSA and depth of burns. Research objectives: Objectives of this study were to assess %CD3+Ly, % CD4+Ly, %CD8+Ly, %CD3+HLA-DR+Ly, %CD4+Ly /CD8+Ly), of burned body with different %TBSA degrees, different depth burns and to establish predictive value of of immune suppression these parameters. Patients and methods: According to %TBSA, patients were classified into three groups: mild burns with TBSA% <15% (30 patients), group of medium burns with%TBSA from 15% -25% (30 patients) and group with%TBSA> 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups, partial-thickness burns, (39 patients), and full-thickness burns (51 patients). We followed laboratory parameters : % CD3+Ly , % CD3+ CD4+Ly, % CD3+CD8+Ly, % CD3+HLA-DR+Ly, CD4 / CD8 (%) lymphocytes (on day 7th and on day 14th). Results: Percentage of CD3+ lymphocytes was significantly lower in severe burns compared to the moderate heavy burns andsignificantly lower compared to the mild burns . Percentage of CD3+CD4+ lymphocytes was significantly lower in severe burns compared to moderate heavy burns and in relation to mild burns (results on day 14th ); also are lower in moderate severe burn compared to mild burns. On day 14th, the% CD4 / CD8 ratio was not significantly lower in the severe burns versus the moderate burns. On day 14th, the % CD4 / CD8 ratio wassignificantly lower in severe burns compared to mild burns; significantly lower in moderateburns compared to mild burns. % CD3+HLA-DR + cells was significantly lower in severe burn and moderately severe burns compared to the mild burns on day 7th, and also on day 14th . Full- thickness burns have significantly lower %CD3+lymphocytes, %CD3+CD4+ lymphocytes, %CD3+HLA-DR+ lymphocytes, ratio of % CD4/CD8 lymphocytes compared to partial-thickness burns . Conclusions: Peripheral blood T lymphocytes are one of the key indicators of immunosuppression of patients with burns of different % TBSA and different degrees of burn depth. Larger %TBSA and full- thickness burns injected stronger systemic immunosuppresion, compared to smaller %TBSA and partial-thickness burns.
Introduction: Burn, depending on the degree of severity and depth, induces significant pathophysiological response of the body. Our study is the prospective study for assessment of T lymphocyte ...immunological changes in patients with burns, with different degrees of %TBSA and depth of burns. Research objectives: Objectives of this study were to assess %CD3+Ly, %CD4+Ly, %CD8+Ly, %CD3+ HLA-DR+Ly, %CD4+Ly /CD8+Ly), of burned body with different %TBSA degrees, different depth burns and to establish predictive value of immune suppression these parameters. Patients and methods: According to %TBSA, patients were classified into three groups: mild burns with TBSA% < 15% (30 patients), group of medium burns with %TBSA from 15%-25% (30 patients) and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups, partial-thickness burns, (39 patients), and full-thickness burns (51 patients). We followed laboratory parameters: % CD3+Ly, % CD3+ CD4+Ly, % CD3+CD8+Ly, % CD3+HLA-DR+Ly, CD4 / CD8 (%) lymphocytes (on day 7th and on day 14th). Results: Percentage of CD3+ lymphocytes was significantly lower in severe burns compared to the moderate-heavy burns and significantly lower compared to the mild burns. Percentage of CD3+CD4+ lymphocytes was significantly lower in severe burns compared to moderate-heavy burns and in relation to mild burns (results on day 14th); also are lower in moderate-severe burn compared to mild burns. On day 14th, the% CD4 / CD8 ratio was not significantly lower in the severe burns versus the moderate burns. On day 14th, the % CD4 / CD8 ratio was significantly lower in severe burns compared to mild burns; significantly lower in moderate burns compared to mild burns. % CD3+HLA -DR + cells was significantly lower in severe burn and moderately severe burns compared to the mild burns on day 7th, and also on day 14th. Full-thickness burns have significantly lower %CD3+lymphocytes, %CD3 +CD4+ lymphocytes, %CD3+HLA-DR+ lymphocytes, ratio of % CD4/CD8 lymphocytes compared to partial-thickness burns. Conclusions: Peripheral blood T lymphocytes are one of the key indicators of immunosuppression of patients with burns of different % TBSA and different degrees of burn depth. Larger %TBSA and full-thickness burns injected stronger systemic immunosuppression, compared to smaller %TBSA and partial-thickness burns
Autoimmune diseases occur in 3−5% of the population. Study included 30 patients with clinically diagnosed SLE and 30 healthy controls (American college of Rheumatology, 1997). SLE was diagnosed ...according to criteria issued in 1997 by the American College of Rheumatology (ACR). The aim of this study was to evaluate concentration values of each antigen of ENA-6 profile in SLE, to investigate possible correlation between the concentration of Sm antibodies and CIC, and to test their use as possible immunobiological markers in SLE. Furthermore, the aim of our study was to determine whether there is a correlation between Sm antibodies and CIC and SLE activity. The results revealed that all of these ENA-6 and Sm antibodies as biomarkers complement diagnoses of active SLE but their use as solo markers does not allow classifying patients with SLE. Our study has shown that based on calculations from ROC curves, Sm/RNP was clearly a very important marker for diagnosis of SLE (cut off ≥ 9.56 EU, AUC 0,942). The high incidence of Scl-70 (10%) reactivity suggests that ELISA monitoring of this antibody produces more false positive results than other multiplex assay. An important conclusion that can be drawn from the results of our study is that laboratory tests are no more effective than clinical examination for detecting disease relapse, but are helpful in the confirmation of SLE activity.
Regulatory T cells (Treg) play a central role in the immunopathogenesis of psoriasis. Immunoregulatory T cells (Tregs) are involved in important homeostatic mechanism for maintaining tolerance and ...preventing autoimmunity, and autoimmune diseases. The aim of this study was to examine the role of Tregs cells in the pathogenesis of psoriasis, and determine the range value for Treg cells (CD4+ CD25+) in the peripheral blood of patients with psoriasis compared to the severity of disease.
The study included 51 patients diagnosed with psoriasis and 25 healthy individuals. Phenotype profile of peripheral blood lymphocytes was determined by flow cytometry, and assessment of severity of disease was determined on the basis of PASI score (e.g. Psoriasis Area and Severity Index).
Proportion of CD4+CD25+T cells in the control group was significantly higher than in the patients with psoriasis 6,4% ±(5,4-7,6) vs. 4,1% (3,1 -5,8)-Mann-Whitney U test, p <0.001. In the present study we did not find a statistically significant correlation between the levels of CD4+CD25+cells, in patients with psoriasis, compared to the severity of disease-PASI. (i.e. Pearson correlation, r = 0.197, p = 0.194).
The stratification of patients, according to the severity of the clinical course was not possible on the basis of Treg cells' level. ROC curve analysis of the optimal cutoff (PASI=10) and the CD4+CD25+, which distinguishes between patients and healthy individuals was 5% of CD4+CD25+ of the total number of CD4+ lymphocytes with specificity of 69% and sensitivity of 84%.
Alopecia areata (AA) is a heterogeneous disease characterized by nonscarring hair loss on the scalp or other parts of the body. A wide range of clinical presentations can occur-from a single patch of ...hair loss (alopecia unilocularis, AUl), multiple patches (alopecia multilocularis, AM) to complete loss of hair on the scalp (alopecia totalis, AT) or the entire body (alopecia universalis, AU). The cause of AA is unknown although most evidence supports the hypothesis that AA is a T-cell mediated autoimmune disease of the hair follicle and that cytokines play an important role. The aim of the study was to evaluate serum concentrations of interferon-gamma (IFN-g) in patients with AA and the healthy subjects and also to assess a possible association between IFN-g and clinical type and duration of the disease. Sixty patients with AA and 20 healthy controls were enrolled in the study. Serum concentrations of IFN-g were determined by ELISA method. The serum concentration of IFN-g in patients with AA was significantly higher than that in the control group (10.62±1.09 pg/mL vs 10.02± 0.62 pg/mL, respectively). Significantly elevated serum IFN-g were noticed in patients with AU type (11.81±1.11 pg/mL), expecialy those suffering from AT (12.30±0.93 pg/mL), compared with both patients with AUl (10.20±0.59 pg/mL) and patients with AM clinical type (10.21±0.78 pg/mL). There was no significant difference in serum IFN-g concentration between patients with AUl and AM group, as well as between patients with AT and AU. No correlations were found between duration of disease and the serum levels of IFN-g. Our findings confirm previously published data that the Th1 type cytokine IFN-g is elevated in the serum of AA patients. Key words:
Vitiligo is an acquired skin disorder characterized by depigmented maculae resulting from a reduction of the number and function of melanocytes. The etiopathogenesis of the disease is still unclear, ...but there is evidence that autoimmunity may be involved.
The aim of this study was to determine the prevalence and significance of antinuclear (ANA) and thyroid peroxidase (anti-TPO) antibodies in patients with vitiligo and control group.
In a prospective case-control study, we compared the frequency of antibodies (ANA and anti-TPO) in 40 patients with vitiligo and in 40 healthy volunteers.
ANA were positive in 7 (17%) patients, which was insignificantly higher than control group, 2 (5%). Anti-TPO were positive in 11 (27%) patients. In control group, only two subjects (5%) had positive anti-TPO. Compared with the control group, the frequency anti-TPO were significantly higher in those with vitiligo (p < 0.05).
Our findings show a significant association between vitiligo and thyroid autoimmunity, and that tests to detect anti-TPO are useful markers in patients with vitiligo. In contrary, ANA seems to have limited diagnostic relevance in routine clinical practice. Additional studies of a wider sample are warranted to confirm these findings and allow a detailed analysis.
Anti GAD (antibodies on glutamic acid decarboxylase) and anti-IA2 antibodies (against tyrosine phosphatase), today, have their place and importance in diagnosis and prognosis of Type 1 diabetes. Huge ...number of patients with diabetes mellitus type 1 have these antibodies. Insulin antibodies are of critical importance in diagnosis of diabetes mellitus type 1 for pediatric population.
During 2014, the samples of 80 patients from Clinical Center University Sarajevo (CCUS) Pediatrics clinic's, Endocrinology department were analyzed on anti-GAD and IA2 antibodies. The samples of serums of all patients were analyzed with ELISA tests using Anti GAD ELISA (IgG) kites from EUROIMMUN company. These are quantitative in vitro tests for human antibodies against decarboxylase of glutamine acid (GAD) and IA2, in serum or EDTA plasm.
During the period of one year, in CCUS's Organizational unit, Institute for Clinical Immunology, 80 samples of patients with anti GAD and IA2 antibodies were analyzed. Out of total number of samples, 41 were male patients, or 51% and 39 female, or 49%. The youngest patient was born in 2012, and the oldest in 1993. Age average was represented by the patients born in 2001. Share of positive results for IA2 antibodies and GAD antibodies was 37% for IA2 antibodies, and 63% for GAD antibodies.
During an autoimmune - mediated Diabetes mellitus type 1 leads to T-cell mediated destruction of beta cells of pancreatic islets, reduced production of insulin and glucose metabolism. Studies have shown that these bodies are the most intense single marker for identifying persons with increased risk for diabetes development.
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